Blood-Based Screening Has Acceptable Accuracy for Colorectal Cancer Detection

THURSDAY, June 12, 2025 (HealthDay News) — A blood-based test has acceptable accuracy for colorectal cancer detection but not for advanced precancerous lesions in an average-risk colorectal cancer screening population, according to a study published online June 2 in the Journal of the American Medical Association.

Aasma Shaukat, M.D., M.P.H., from the New York University Grossman School of Medicine in New York City, and colleagues conducted a prospective, multicenter, cross-sectional observational study enrolling asymptomatic adults aged 45 to 85 years. Individuals had an average risk for colorectal cancer and were willing to undergo a standard-of-care screening colonoscopy to examine the clinical performance of an investigational blood-based circulating tumor DNA test for colorectal cancer detection. The evaluable cohort included 27,010 participants with a median age of 57.0 years. Participants completed a screening colonoscopy after blood collection.

The researchers found that the sensitivity was 79.2 percent for colorectal cancer, and specificity was 91.5 percent for advanced colorectal neoplasia. For advanced colorectal neoplasia, the negative and positive predictive values were 90.8 and 15.5 percent, respectively. All of the primary end points met the prespecified criteria for acceptance. For advanced precancerous lesions, sensitivity was 12.5 percent, which did not meet the prespecified acceptance criterion.

“In an average-risk colorectal cancer screening population, a blood-based test demonstrated acceptable accuracy for colorectal cancer detection, but detection of advanced precancerous lesions remains a challenge, and ongoing efforts are needed to improve test sensitivity,” the authors write.

Several authors disclosed ties to biopharmaceutical companies, including Freenome Holdings Inc., which funded the study.

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